Blood-Borne Infectious Disease Reporting Form

Hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) are the three most common blood-borne pathogens. Provider-to-patient transmission is a rare but serious event. As such, precaution, appropriate to the situation, should be practiced to minimize the possibility of transmission. Many states include reporting of infection status as a part of licensure.

The University of Minnesota School of Dentistry considers it a professional and ethical responsibility to be aware of one’s own infection status for HBV, HCV, and HIV. No student will be required to undergo mandatory testing; however, students who believe they are at risk should have themselves tested.

Infection with HBV, HCV, or HIV should be self-reported to Dr. Self, the Office of Academic Affairs, and members of the Blood-Borne Infectious Disease Review Panel. Consistent with the self-reporting requirements imposed on physicians and other regulated healthcare workers under Minnesota law, Minn. Sta. 214.19 Subd. 2, this reporting obligation is mandatory for students infected with HBV, HCV, and HIV. Failure to self-report is basis for disciplinary action by the School of Dentistry.

The review panel will assess students' level of risk and make reasonable accommodations where needed. Copies of the School of Dentistry Policy for Students with Blood-Borne Diseases may be requested through Dr. Mercedes Porter (port0194@umn.edu), Office of Student and Resident Affairs.

Complete the Blood Borne Infectious Disease Reporting Form by July 11, 2025:  z.umn.edu/bbidrf2025